Phlebotomy National Exam Study Guide

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I cannot be held responsible if you do NOT pass the National Exam. This information is ONLY for your review.

OSHA

Occupational Saftey & Health Administration

What vaccination does OSHA require all health care personnel get?

OSHA requires that all health care personnel exposed to blood and other bodily fluids must receive a vaccination against Hepatitis B

Pulmonary Edema

Fluid in the lungs

How much blood can a person donate in a session?

500 mL

Patients have the right to what?

Under the Patient Bill Of Rights they always have the option to decline medical treatment and to know what tests are being performed on them.

What can you NOT give a patient?

Results or a diagnosis. Because you are not medically qualified to do so.

Negligence is?

Failure to give appropriate care. DON'T BE NEGLIGENT!

PPE stands for?

Personal Protective Equipment

One of the most important practices is?

Hand Washing is one of the most important (and easiest) practices used to prevent transmission of bloodborne pathogens

Needles should never be

recapped

Sharps containers must be what?

puncture-resistent, leak proof on the sides and bottom and must be labeled or color-coded

Types of Hazards

Biologic - Infectious agents that can cause bacterial, viral, fungal or parasitic infections

Sharps - Needles, lancets and broken glass can puncture and cut, causing blood-borne pathogen exposure

Chemical - Preservatives and chemicals used in the laboratory. Exposure to Toxin, Carcinogenic or caustic substances

Fire or explosive - bunsen burners, oxygen and chemicals can cause burns or dismemberment

Physical - wet floors, heavy lifting ance cause falls, sprains and strains

ALLERGIC reaction * - Latex sensitivity is a PHYSICAL reaction to care worker allergic reation to the patient

In infection control WHO is the agent?

Person

In infection control WHAT is portal of exit?

Needle

In infection control WHAT can we control?

Mode Of Transmission OR exit of infection

In infection control WHAT is a portal of entry?

Mucas membrane

In infection control WHO is a susceptible host?

Person

Mode of Transmission

Specific ways in which microorganisms travel from the reservoir to the suseptible host

Five main types or mode of transmission

contact - direct and indirect (fomite)
Droplet - Cold, Flu and sneezing
Airborne - viral - breath in
common vehicle - person, fomite and not handwashing
vector borne - illness that is transmitted through an invertebrate, such as an insect

Mode of infection

the point in the infection chain where we aim at preventing the spread of infectious disease

Standard precautions do what?

Infection control method designed to prevent direct contact with blood and other body fluids and tissues by using a barrier of protection and work control practices.

What do we assume all patients to be?

Patients are presumed to be infective for blood-borne pathogens

Standard precautions consist of what itmes?

Gloves - when collecting and handling body fluids, or tissue specimen
Face shield - when danger of splashing on mucous membranes
Disposal - dispose of all needles and sharp objests in punture-proof containers, WITH OUT RECAPPING
Disinfectants - clean fluid spills, thus killing pathogenic organisms

Medical Asepsis

This condition is best defined as "the destruction of pathogenic microorganisms after they leave the body". It also involves enviromental hygien measures such as equipment cleaning and disinfection procedures. Methods of medical asepsis are Standard Precautions and Transmission-based Precautions

What are barrier protections?

Masks
Gloves
Face Shields
Resirator
Gloves

How do you remove PPE equipment?

1st - Gloves
2nd - Gown
3rd - Shield

What type of soap should be used?

Non-abrasive, antibacterial soap.

What do you do if blood splashes in the eye or mucous membane?

Flush with warm water (hotter the better) for 15 minutes
Report incident exposure to your supervisor ASAP!

Who cannot be identified in an incident report?

a minor

Bedside manner includes?

introduce yourself, ask patient name and b-day. Explain what you will be doing. Chat with patient to keep mind off poke. ADVISE them WHEN you are poking! Speak to them on a first name basis

What phase is best practice

"pleasant with the patient and professional with the poke".

If patient has an I.V. where do you draw blood?

Downstream from the I.V.

Double Mastectomy patients should ONLY have blood drawn from what?

Hands

Left Mastectomy patients should have blood drawn from what side?

Right side

What is a Fistula?

artificial connections of veins

What is a Graft?

artificial artery connection to vein

Sclerosis is?

Hard and cord like veins

For obese patients what vein is used?

Cephalic Vein is most likely to be the one you can palpate and draw blood from in an obese patient

Cephalic means what?

Head

Most common complication in Phlebotomy

Hematoma

To prevent a Hematoma

prevented if pressure is placed on the venipuncture site until bleeding stops

If a patient faints what is the 1st thing to do?

GET the needle out of the arm

Vasovagal Syncope is

fainting, dizziness before, during or after venipuncture

Circulatory System funtion

is todeliver oxyge, nutrients, hormones and enzymes to the cells. Transport cellular waste such as carbon dioxide and urea to the organs where they can be expelled from the body.

Circulatory exchange is done where?

capillary level

45% of blood is

formed elements -
Erythrocytes (red blood cells) = 99% of formed elements.
Leukocytes (white blood cells) and Thrombocytes (platelets)

All blood cells originate from

stem cells in the bone marrow

The heart acts as what?

two pumps (right and left sides)

Left and right sides of heart are connected by

two circulations, with each pump equipped with two valves the function of which is to maintain a one way flow of blood

Pulmonary circulations

carries deoxygentated blood from the right ventricle to the lungs. (alveoli) and return oxygenated blood from the lungs to the left atrium

Oxygenation takes place

at the alveoli - sacks in the lungs

Systemic circulation

carries oxygentated blood from the left ventricle throughout the body

Tricuspid valve

an atrioventricular valve, being situated between the right atrium and the right ventricle

Pulmonic valve

semi lunar valve situated between the right ventricle and the pulmonary artery

Mitral valve

(bicuspid valve) is another atrioventricular valve, being situated between the left atrium and the left ventricle

Aortic valve

semi lunar valve situated between the left ventricle and the aorta

How long does it take for a full circulation?

one minute

The average person weighting 155 pounds has

approximately 5-6 liters of blood in their system.

Blood composes of

7-9 percent of total body weight of a person

Blood has how much plasma?

55% is plasma

Plasma is what?

a clear, pale yellow fluid

what does plasma do?

it carries nutrients, lipids, glucose, sodium, magnesium, calcium, potassium, oxygen, carbon dioxide, nitrogen, antibodies, as wells as vitamins and hormones ect.

What is 45% of blood?

Red blood cells, White blood cells and Platelets. Known as the formed cellular elements

How long does your body take to regenerate RBC you lose during donation

6 to 8 weeks if you donate the maximum of 500 mL

Three layers of the heart are?

Endocardium
Myocardium
Epicardium

Endocardium

the endothelial inner layer lining of the heart

Myocardium

the muscular middle layer. This is the contractile element of the heart

Epicardium

the fibrous outer layer of the heart. The coronary arteries, which supply blood to the heart are found in this layer

Blood vessels are

Aorts, arteries, arterioles, capillaries, venules and veins, superior and inferior vena cava

Erythrocytes

Red blood cells or RBC's

Erthrocytes contain

hemoglobin, the oxygen-carrying protein.

Hemoglobin

enters the blood as an immature reticulocyte where in one to two days, it matures into erythrocyte.

How many RBS's per microliter

4.2 to 6.2 million RBC's per microliter of blood.

What is the normal life span of RBC's

is 120 days

What is leukocytes function

provide the body protection against infection.

How many WBC's for adults per microliter

5,000 to 10,000

Leukocytosis is?

an increase in WBC's, is seen in the case of infection and leukemia.

Leukopenia is what?

a decrease in WBC's, is seen with viral infection or chemotherapy

How many types of WBC's are in the blood

Five

A differential count does what?

determines the percentage of each type

Neutrophils are what?

phagocytic cells, meaning, they engulf and digest bacteria. Their number increase in bacterial infection.

Neutrophils comprise how much of the WBC's population?

40 to 60% of the WBC population

Lymphocytes do what?

their numbers increase in viral infection, they also play a role in immunity.

Lymphocytes comprise how much of the WBC population?

20 to 40% of the WBC population

Monocytes do what?

Increase in intracellular infections and tuberculosis

Moncytes comprise how much of the WBC population?

3 to 8%, they are also the largest WBC's

Eosinophils do what

they are active against antibody-labeled foreign molecules.

Eosinophils increase

in allergies, skin infections and parasitic infections

Eosiniphils come

first in allergic reactions. During an allergic reaction it would show an increase in Eosinophil count

Basophils do what

release histamine

Basophils count for what of the WBC population?

0 to 1% in the blood

Thrombocytes are essential for what?

blood coagulation

Thrombocytes are also know as

platelets are small irregularly shaped packets of cytoplasm formed in bone marrow

Three major veins are located

in the antecubital fossa

The three major veins are?

Median cubital vein
Cephalic vein
Basilic vein

1st order of draw

Red topper tube

Red top tube also known as

plain vacume tube and contains no additive or anticoagulant.

collected blood clots, by normal coagulation process is

30 minutes

Do you need to invert a Red Tube

No

Common test for red tubes are

Serum chemistry, Serology, Blood bank

Arteria Blood Gas (ABG) sample must be run within

15 minutes of collection

Arterial blood is used to determine

blood gas levels and blood PH. Usually collected by a nurse or respiratory therapist

Basal state is

When the patient has fasted and not excersiced in 12 hours

Do you note if a patient has not fasted?

YES!

2nd order of draw tube color is

Light blue

Light blue tube has what additive

Sodium Citrate
Different ratios

Light blue tubes MUST be inverted how many times

5 to 10

Light blue tubes are used to test

coagulation determinations on plasma specimens.
Certain test require chilled specimens
Always fill to MAX fill line

3rd order of draw tube color is

Tiger top or gold top (gold in Utah)

Tiger top / Gold top tubes have what additives

Clot activator - (silica in Utah) or glass particles
Fixotropic gel

Blood cagulates with additive in

15 to 30 minutes

4th order of draw tube color(s) are

Green top
Mint top
Hash marks on label

Green top tube has what additives

Heparin combined with sodium, lithium or ammonium ion

Mint green top tube has what additive

PST - Plasma Seperator tube

Hash marked tube has what additive

Sodium Heparin

Common tests for Green tubes are

Ammonia
Carboxyhemoglobin ( HCg preg test)
STAT Lytes

LYTES are

electoliytes - potassium, sodium

BMP Panel is

Basic
Metobolic
Panel

A Panel is

A group of tests ordered together

Sodium additive tubes test for

Lithium

5th order of draw tube color is

Lavendar

Lavendar tube has what additive

EDTA - Ethylenediaminetetraacetate

BMP - chem 8 Tiger/Gold tube

Basic Metobolic Panel

CMP - chem 14 Tiger/Gold tube

Comprehensive Metobolic Panel

Drk purple tube has

7. mL of EDTA - calcium binding agent

Lt purple tube has

3.6 mL of EDTA - calcium binding agent

Pink top tubes are used for

Blood banks / transfusion - for blood typing

Lavendar top tubes are used for

CBC = Complete Blood Count
CBCAN = Complete Blood Count Automatice Differential
CBCDN - Complete Blood Count Manual Differential

ESR - Lavendar top tub

Erythocyte Sedimentation Rate

ESR tests for

Sickle Cell Screening

EDTA

inhibits coagulation by binding to calcium in the specimen

What tube is used for coagulation studies?

Light Blue

Tubes must be filled

at least two-thirds full

Tubes must be inverted

8 times

Hematocrit measures

the percentage of the RBC's (Red Blood Cells) in a given volume of whole blood

What test is ALWAYS given before blood donation

Hematocrit

1- blood enters the heart

Superior & Inferior Vena Cava (V-C)

2- goes to

Right Atrium

3- from there to

Tricuspid Valve

4- then onto

Right Ventricle

5- and now out to the

Pulmonary Artery - and lungs

6- back into the

Pulmonary Veins

7- then onto the

Left Atrium

8- moves onto the

Bicusped Valve

9- down to the

Left Ventrical

10- finally to your hot bod via the

Aorta

Veins have

Valves

ABG (Arterial Blood Gas)

Analyes arteial blood for oxygen, carbon dioxide and bicarbonate content in addition to blod PH
* used to determine the effectiveness or respiration

Aseptic

The absence of microoganisms or by contrast, something that just discourages the growth of microoganisms is antiseptic

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